Labour Productivity Impact of Respiratory Infections in the Netherlands

OBJECTIVES: Respiratory infections do not only present an increasing burden to health-care systems but also lead to relevant sickness leave with corresponding production losses. An increasing number of vaccines for respiratory conditions are available, ranging from established ones such as for influenza and novel ones as for respiratory syncytial virus. Application in overall healthy working adults is considered to potentially avoid sickness leaves, however, healthy working adults generally have a low coverage of respiratory vaccines. We aim to estimate the size of sickness leave in The Netherlands, related to respiratory conditions and the potential for respiratory vaccines to reduce this burden.

METHODS: Data on sickness leave were taken from two public sources: National Survey Working Conditions (TNO Institute) and Central Bureau of Statistics. For vaccine effectiveness, a targeted review was done on various respiratory infections, focussing on the working-age population. In the end, we integrated clinical trial and real-world data on existing and investigational respiratory single and combination vaccines into a plausible vaccine effectiveness model.

RESULTS: In recent years, annually 80.6 Mio days of sickness leave were reported in the Netherlands (around 5% of all working time), of which an estimated 26.9 Mio relates to respiratory diseases. Our integrated estimate for effectiveness of vaccination against respiratory infections rounds towards a conservative 60%, with a credibility interval for sensitivity analysis of 40 to 80%. Applying these estimates results in the potential avoidance of 8.1 Mio (5.4-10.7) sickness days assuming 50% uptake.

CONCLUSIONS: Our analysis shows that a relevant amount of days absence due to sickness leave can be avoided at 8.1 Mio in The Netherlands, reflecting 10% of all sickness days. In times of staff shortages this is an opportunity for both the Dutch government and employers to invest in vaccination programmes for the working population, potentially increasing labour productivity with billions of euros annually.